CARE HOMES FOR OLDER PEOPLE
Kenwyn Newmills Lane Kenwyn Hill Truro Cornwall TR1 3EB Lead Inspector
Diana Penrose Key Unannounced Inspection 25th July 2006 09:10 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Kenwyn Address Newmills Lane Kenwyn Hill Truro Cornwall TR1 3EB 01872 223399 01872 223884 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Barchester Healthcare Amanda Jane Trotter Care Home 108 Category(ies) of Dementia - over 65 years of age (34), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (34), Old age, not falling within any other category (60), Physical disability (14), Terminally ill (60) Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. Pencarrow & Trelissick - Residents to include 60 adults of old age (OP) Pencarrow & Trelissick - Residents to include up to 60 adults with a terminal illness (TI) Tresco Unit - Residents to include up to 34 adults aged over 65 with a mental illness (MD{E}) Tresco Unit - Residents to include up to 34 adults aged over 65 with dementia (DE{E}) Glendurgan Unit - Residents to include up to 14 adults aged 18 to 65 years on admission with a physical disability (PD) To include one named resident under the age of 65 years in Tresco Unit Total number of residents not to exceed a maximum of 108 To include one named resident under the age of 65 years in Trelissick / Pencarrow Unit 26th January 2006 Date of last inspection Brief Description of the Service: Barchester Healthcare owns Kenwyn Nursing Home and a large number of homes throughout the country. Kenwyn is situated on the outskirts of the City of Truro. It is a very large home that offers both residential and nursing care for up to 108 people. The service provides care and accommodation for residents who experience differing care needs; older people, nursing, dementia, mental disorder, physically disabled and terminally ill. Accommodation is on two floors and divided into four separate units. There are two lifts accessible to residents. There are four double bedrooms the rest are single, all have en suite facilities and all rooms have accessible call bells. Meals are prepared in a well-equipped kitchen on the ground floor. There is a secondary kitchen on the first floor. Meals are served in the dining rooms on each unit or individual bedroom if preferred. The large dining room upstairs is equipped with a servery so residents can choose their meal and it is served hot. The extensive grounds are attractive, well maintained. There are however some access limitations for wheelchair users given certain gradients on some of the pathways. There are patios with seating and tables. Car parking space is provided.
Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 5 A Senior Nursing Sister supported by a team of qualified nurses and care staff manage each unit. The Hotel Services Manager is responsible for the catering and domestic staff. Two Recreational Therapists are employed to organise activities and trips out. There are good opportunities for socialising and visitors are actively encouraged. Information about the home is available in the form of a residents’ guide, which can be supplied to enquirers on request. A copy of most recent inspection report is available in the home. Fees range from £444.25 to £1522.36 per week; this information was supplied to the Commission in the pre inspection questionnaire received on 29/06/06. Additional charges are made in respect of private healthcare provision, hairdressing and personal items such as newspapers, confectionary and toiletries. Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. Three inspectors visited Kenwyn Nursing Home on the 25 and 26 July 2006 and spent nine and a half hours at the home. This was a key inspection and a planned unannounced visit. The purpose of the inspection was to ensure that residents’ needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus was on ensuring that residents’ placements in the home result in good outcomes for them. It was also to gain an update on the progress of compliance to the requirements identified in the last inspection report dated 26/01/06. All of the key standards were inspected. On the day of inspection 102 residents were living in the home. The methods used to undertake the inspection were to meet with a number of residents, relatives, staff and the management to gain their views on the services offered by Kenwyn Nursing Home. Records and policies and procedures were examined and the inspectors toured the building. This report summarises the findings of this inspection. Residents and relatives expressed satisfaction with the care and services provided at the home. Overall the home is providing a good quality of care to the residents placed there, with notable improvements over the past year. What the service does well:
The home is a purpose built property that is well maintained. It provides a spacious environment that is warm, clean and well furbished. Residents spoken with were happy in the home and had their own possessions around them. The grounds are extensive and very well maintained. The home has won several awards for its gardens; last year they won the Barchester in bloom award. Residents have a gardening club and can participate in growing flowers and vegetables. A member of the management team assesses prospective residents to ensure the home can meet their needs. The assessment involves relatives and health professionals as necessary and records are kept. An individual plan of care is compiled from the initial assessment that directs staff in the care to be provided. The home aims to respect individuality and disability and sexuality for example are included in the care plans. A number of risk assessments are undertaken, for example to prevent pressure sores, to ensure adequate nutrition and to prevent falls. The nurses maintain individual daily records, and they are informative. Residents said their healthcare needs are met, they are treated with respect and their privacy is upheld; this was seen to be so during the inspection. Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 7 There is a medicines policy and system in place for the ordering, storage, administration and disposal of medicines. A qualified nurse administers the medicines at all times. There are two activities co-ordinators who organise activities, entertainment and trips out for the residents. Residents are given a programme of events and records are kept. Residents said they could receive visitors when they wish and their individuality and personal preferences are respected. Where required residents have a nutritional needs assessment to identify any specific dietary needs. Meals are served in the dining areas or individual bedrooms. The addition of a servery in the main dining room has improved the dining experience for residents and visitors. The menu is very varied with fresh fruit and vegetables on offer every day. There is a variety of finger food and omelettes and a sweet trolley. Hotel services staff deal with the food and refreshments. Residents and visitors said the food is very good and well presented. There is a satisfactory complaints procedure that ensures complaints are dealt with promptly and there are systems in place to safeguard residents from abuse. There is a robust recruitment process in place with relevant checks made and records kept. There are sufficient numbers of staff on duty and residents said the staff are kind and caring. There is an induction programme for new employees and relevant training is offered to all staff. The management strive to improve services and the care provided by a range of audits and surveys. Regular meetings take place with staff, residents and GP practices. There is a comments book in reception and residents said they could talk freely to the staff and management if they needed to. The home only holds money for residents if really necessary and has an appropriate system in place. What has improved since the last inspection?
The registered manager has ensured that the requirements notified at the last inspection have been met. The care planning records have improved with the introduction of new documentation; this is being implemented throughout the home. A local medicines policy has been implemented. New pressure relieving mattresses and cushions have been purchased along with two new Arjo hoists. Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 8 A Home Trainer has been employed who is sorting out staff training. Several posters are displayed informing staff of study days and courses and a monthly training newsletter is circulated. Electronic records have been set up. The servery in the upstairs dining room has been completed and provides an excellent facility. Training is being provided for staff on enhancing the dining experience for residents. Four bedrooms per quarter are being refurbished and residents are pleased with the results. The corridor carpets are in the process of being replaced; the upstairs corridor carpet was being fitted during the inspection. A new carpet-cleaning machine has been purchased and odour-reducing crystals are used to eliminate offensive odours. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 10 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (6 is not applicable) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are only admitted to the home following an assessment of their needs to ensure the home can provide suitable care. EVIDENCE: Evidence was provided in the form of records, interviews with residents, relatives, staff and registered manager. Completed assessment documents were inspected and the process explained by staff. Residents and relatives spoke positively about the assessment process and said they visited the home prior to any decisions being made. The document has a section to record who is involved in the assessment and information from Adult Social Care and hospital staff is obtained when appropriate. Forms inspected were completed appropriately, dated and signed. A further assessment is undertaken on admission to the home and an individual plan of care is compiled from the assessments. Relatives said that information was given to them about the home prior to any decisions being made.
Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 11 Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 12 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual care plans are generated for each resident that inform and direct the staff in the care provision. Residents have access to health care services as necessary to ensure their assessed needs are met. There are systems and policies in place for dealing with residents medicines that assure residents safety, some additions to the policy will further inform staff. Systems are in place to ensure that residents are respected and their privacy is upheld at all times. EVIDENCE: Evidence was provided in the form of documentation, records, observation, interviews with residents, relatives and staff. Each resident has a written care plan. The new system is well into the process of implementation; these documents provide much more information and direct staff more fully in the care to be provided. The planning for social, religious and emotional needs has not been fully addressed and must receive more attention. Some residents do have a life history included in their file. Diverse needs, sexuality and disabilities are addressed. Care plans are reviewed monthly and changes are recorded. Relevant risk assessments are
Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 13 included and the moving and handling risk assessment has greatly improved. There is some evidence that care plans are compiled with the resident or representative and signed in some cases, the recording could be improved to state a reason if not signed. Daily records are maintained and are informative. Doctors and other healthcare professionals visit as appropriate and records are kept. A visiting GP said he was happy with the care provided by the home. Residents spoke of going to the hospital for appointments. The home has suitable equipment for moving and handling and pressure relief, new mattresses and cushions have been purchased along with two new Arjo hoists. There is a corporate medicines policy and a new local policy for the administration of medicines. The new policy must be updated to include the use of medicinal gases, creams and lotions, insulin and the use of the drug fridge, for example. Medicine reference books are current. Storage of medicines is safe and secure. Medicines received into the home are recorded and signed for on the medicine administration chart. Medicines are disposed of appropriately with records maintained. One or two medicines were noted as not signed as given or a reason recorded for omission on all units, this was discussed with the registered manager and must be addressed. One nurse was observed to leave the medicine trolley unlocked and unaccompanied during the lunchtime round, this was also discussed with the registered manager who said she would take this up with the nursing staff. Residents’ privacy was upheld during the inspection. Residents said they are treated with respect and their privacy is upheld at all times. Shared rooms are provided with appropriate screens. Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a range of activities and aims to offer a lifestyle that meets individual residents needs. Links with family, friends and the community are good and allow residents the opportunity to socialise. Residents are helped to maintain control over their lives and staff respect their individual preferences and choice. Dietary needs of residents are well catered for with a varied selection of food available that aims to meet their taste and preference. EVIDENCE: Evidence was provided in the form of documentation, records, observation, interviews with residents, relatives, staff and registered manager. The home has two activity co-ordinators who organise activities in the home; residents can choose whether or not to join in. One co-ordinator was on sick leave at the time of the inspection so activities observed were minimal. There is a written guide for staff on integrational activity. Activities noted include bingo, quizzes, reminiscence, hangman and hand massage. There is an activities area next to the upstairs lounge. Some residents participate in the gardening club and have grown flowers, potatoes, cucumbers and tomatoes. There is one to one social interaction and residents are given opportunities to go out on trips. Residents spoke of their trip to Stithians agricultural show and
Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 15 one resident said she went to bird paradise recently at Hayle. The home held a fete recently and residents were very involved with this. The records of activities are held in files separate to the rest of the resident’s notes; it is recommended that the records be amalgamated. Residents said they choose when they get up and go to bed. They choose what clothes to wear and how they spend their day. They said they receive visitors when they wish and can receive them in private, the visitor’s book showed that several people visit the home each day. It was observed that one resident went out with her son and another went out into the grounds with her husband during the inspection. The registered manager said that residents are encouraged to live their lives as they wish according to their ability. Where required each resident has a nutritional needs assessment and the likes and dislikes are recorded for each resident. There is a varied menu that spans six weeks. The menu includes finger food and omelettes and a sweet trolley with fresh fruit is available each day. Most residents said the food is very good and it was certainly observed to be very good, with a great deal of choice available. Meals are served in the dining areas or individual bedrooms. Meals are very well presented and appropriate assistance is given in a relaxed manner. A new servery has been included upstairs and allows meals to be staggered; it also enables residents to choose their meal at the table. Barchester Healthcare have a ‘cooking with care’ initiative taking place at the moment that has been headed by a celebrity chef. The home are promoting the initiative with a display in reception with free recipe cards. The Company have their own Chef Academy providing training each year there is an interhome chef’s competition. Training is available to staff in house on enhancing the dining experience for residents. Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 16 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure that ensures complaints are listened to and acted upon. Arrangements are in place for the protection of residents safeguarding them from harm or abuse. EVIDENCE: Evidence was provided in the form of documentation, records and interviews with registered manager. There is a suitable complaints policy in the home and a method for recording complaints, the action taken and the outcome. There have been 6 complaints since the last inspection all of which have been dealt with promptly. One was from a member of staff, one was concerning a missing item and the others were regarding the care of residents. Two were partially substantiated. Thank you letters and cards are kept. There is an adult protection policy that includes the local inter agency procedures. Information received at recent training events is also held in the file. Staff have been attending local training days. All staff receive in house adult protection training that includes a video. Residents said there are no barriers to raising concerns with the management. There is a secure facility for the storage of money in the home. Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good this judgement has been made using available evidence including a visit to this service. The home and grounds are well maintained providing a safe environment for residents, staff and visitors. The home is very clean and every effort is made to eliminate unpleasant odours making it a pleasant place for residents to live in. EVIDENCE: Evidence was provided in the form of a tour of the building, interviews with residents, staff and registered manager. The home is clean and well maintained, refurbishment and redecoration is ongoing. Some residents have chosen the décor for their rooms. Comfortable furniture is provided in the lounges and there are facilities for residents to entertain visitors. Residents said they are happy with their rooms and the facilities provided. Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 18 There are plans to improve the premises and some areas have been completed, these include the fitting of a servery in the upstairs dining room, replacing the corridor lights, refurbishment of a number rooms and the upstairs lounge and the replacement of the corridor carpets upstairs. A review of the colour scheme and signage on Tresco unit has taken place and enhanced the environment for people with dementia. All laundry is dealt with in house, chemicals in the laundry are now stored appropriately. There are adequate sluices with washer disinfectors. Handwashing facilities are appropriate and staff were observed wearing disposable gloves and aprons. Staff said they have attended infection control training. Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels meet the needs of residents and staff morale is good. Residents are in safe hands and benefit from the 50 of care staff trained to at least NVQ level 2 in care. Recruitment procedures are robust and offer protection to the residents. The home provides appropriate training for staff to help them be more competent in their roles. EVIDENCE: Evidence was provided in the form of documentation, records, and interviews with residents, relatives, staff and registered manager. A dependency assessment tool is used to calculate the staffing levels on each unit. Each unit has a Nursing Sister in charge, there is a qualified nurse on duty at all times with a team of care assistants. The registered manager said the home has a full quota of staff at the moment and there appeared to be enough staff on duty during the inspection. Overseas staff employed have settled in well and are appropriately supported by the management (efforts are made to improve communication skills). Staff were very busy especially during the lunch period when staff take their breaks. Residents said the staff are very patient and caring and there are enough on duty. Staff were observed to interact very well with residents, in a kind, relaxed manner. Care practice observed was appropriate and safe.
Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 20 50 of care staff have an NVQ either at level 2 or 3 and copies of NVQ certificates are kept on file. Some staff are currently undertaking NVQ training. There is a robust recruitment procedure. Personnel files inspected contained the records required by legislation. Interview records are maintained and employees receive terms and conditions of employment. There is a generic induction programme for new employees and the new home trainer is reviewing the programme. Induction records inspected had been dated and signed. Staff said they received a good induction to the home. Staff receive training specific to the needs of the individual units. A formal training and development programme is being developed for the home; this is not specific to the separate units. Individual training records are maintained for staff and a matrix is held electronically. A new career development portfolio document has been produced for staff. There are posters around the home advertising training sessions and a training newsletter that is circulated monthly. Training on offer includes POVA, first aid, diabetes and palliative care. Staff said they are satisfied in their roles and the training provision is excellent. Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 21 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager is a person of good character and fit to run the home. The home is run in the best interest of the residents and they benefit from the Quality Assurance systems in place. There is a suitable system in the home for dealing with residents’ money that ensures that the residents’ financial interests are safeguarded. Appropriate training and safety checks are undertaken to ensure the health safety and welfare of residents and staff. EVIDENCE: Evidence was provided in the form of documentation, records, observation, and interviews with residents, staff and the registered manager. The registered manager is competent and experienced to run the home. She is a qualified mental nurse and has achieved the Registered Managers’ Award. She keeps herself up to date on current issues by reading relevant magazines
Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 22 and using the internet. She has worked hard to comply with the requirements and recommendations notified at the last inspection. Staff and residents said the registered manager runs the home very well, is very approachable and treats everyone fairly. Staff appreciate her participation as part of the team and said she works extremely hard. Residents say they can talk to her when they wish and would feel comfortable approaching her if they had a problem. Staff said they are supported in their roles but formal supervision has lapsed in some areas. There is an annual quality assurance survey undertaken with residents and relatives, a copy of the results has been sent to the Commission for Social Care Inspection. Participation is poor and results are reported for the home as a whole, it may be beneficial to undertake a unit specific survey. An anonymous staff audit is undertaken annually. Regular meetings take place with residents, staff and GP practices. There is a comments book in the reception and thank you letters are kept on the units with copies in the office. There is an audit programme that includes health and safety, nutrition and dining, professional practice, medicines and records and record keeping. Action plans are developed for any shortfalls. There is a suitable system in place for the handling of resident’s money. Some residents handle their own money and have lockable facilities in their rooms. Consent is obtained from the resident or their representative allowing the home to handle their money. Receipts are kept and records are maintained for all transactions, double signatures are recorded. The home only holds money for a few residents and this is stored safely and securely. There is a system enabling the home to cash cheques for residents. The management endeavour to ensure that working practices are safe and staff confirmed this. There are health and safety policies and procedures for the home; some of these were inspected. The risk assessments are environmentally focussed and not specific to residents. The aggression and challenging behaviour policy makes no reference to the management of issues or care planning. There is a crisis management plan in place. Fire safety procedures and checks are in place. There is limited reference to the use of oxygen in the home and this must be addressed. Oxygen was observed to be stored safely with appropriate signage in situ. Relevant service checks and maintenance takes place. The moving and handling policy is good and the moving and handling risk assessment has been greatly improved. Staff receive statutory training regularly. There is a person trained in first aid on duty at all times. The kitchen staff have all received food hygiene training. Accident reporting complies with data protection and there is an audit system in place. Accident records for July 2006 were inspected and the number of accidents seem to be above average. There have been multiple accidents or incidents, of a similar nature, with no evidence of risk assessment
Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 23 or review. There needs to be a risk assessment following each accident/incident and a suitable action plan promptly put into place. It was recommended to the registered manager that she complete a monthly analysis on a unit-by-unit basis and that she investigate incidents as appropriate. It was also recommended that she investigate all incidents involving staff. Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP7 OP9 Regulation 15(1) 13(2) Requirement Residents social, religious and emotional needs must be more fully addressed • The local medicines policy must be reviewed and cover all aspects of medications in the home. • All medicines administered must be signed for or a reason given for their omission. Timescale for action 20/11/06 20/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations Care plans should involve the resident or representative and be signed whenever possible, if not the reason should be recorded. • The registered manager should carry out a unit-byunit analysis of accidents each month with
DS0000009256.V297717.R01.S.doc Version 5.2 Page 26 2 OP38 Kenwyn 3 OP33 appropriate investigation, risk assessment and follow up. • Accidents involving staff should be investigated appropriately. Quality assurance surveys should be reported on a unit by unit basis Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kenwyn DS0000009256.V297717.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
